National Provider Identifier
Jan Michal Wieckowski, M.D., PH.D.
Jan Michal Wieckowski, M.D., PH.D. is listed in the NPPES registry with a primary specialty of Ambulatory Fertility Facility in Grand Island, NY and a listed phone number of (716) 773-7927.
Profile Overview
- NPI
- 1740401538
- Provider Type
- Individual
- Primary Specialty
- Ambulatory Fertility Facility
- Enumeration Date
- May 01, 2007
- Last Updated
- July 08, 2007
Practice Location
- 4332 E River RD
- Grand Island, NY 14072-1147
Phone: (716) 773-7927
Specialties
- Ambulatory Fertility Facility (261QA0006X)
Full Record
- NPI
- 1740401538
- Entity Type
- Individual
- Last Name
- Wieckowski
- First Name
- Jan
- Middle Name
- Michal
- Name Prefix
- Dr.
- Credential
- M.D., PH.D.
- Provider Other Last Name
- Wieckowski
- Provider Other First Name
- John
- Provider Other Middle Name
- Michal
- Provider Other Name Prefix Text
- Dr.
- Provider Other Credential Text
- M.D., PH.D.
- Provider Other Last Name Type Code
- 5
- Mailing Street Address
- 4332 E River RD
- Mailing City
- Grand Island
- Mailing State
- NY
- Mailing ZIP Code
- 14072-1147
- Mailing Country
- US
- Mailing Phone
- (716) 773-7927
- Practice Street Address
- 4332 E River RD
- Practice City
- Grand Island
- Practice State
- NY
- Practice ZIP Code
- 14072-1147
- Practice Country
- US
- Practice Phone
- (716) 773-7927
- Enumeration Date
- May 01, 2007
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Ambulatory Fertility Facility (261QA0006X)